4 year old throat clearing and repeating speech and tv when tired

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Our 4y6m daughter started clearing her throat over and over again without being aware of doing it around 6 months ago. Was really noticeable for a while and then at Christmas when had some down time and she got a chance to unwind a bit settled to rarely - the past few months it's mostly just been when she's tired at the end of the day. Recently it's picked up again (re started with a vengeance after a time she hurt herself and got worked up crying a few weeks ago and has stayed on and off a lot more since) and now she is also, only when tired, repeating everything she hears - lines from TV, or things other people say, just under her breath. I read this was classed as echophilia, and is unusual beyond speech development stage - she is definitely far beyond this as she's been a fluent speaker from a young age and has never struggled with putting things in to words.

For context, she is generally very happy all round and enjoys everything she does though she struggles with transitions, can get tired easily and needs a lot of down time and time to herself. This year she's been at school nursery and has struggled a little on and off with adjusting to this - generally loving it and thriving on the routine, social side and especially the academic things they do which she really loves, but finds it very draining sometimes. She doesn't go full time, doesn't like saying goodbye at the door and is still a little reluctant to go in to nursery every morning though loves it when in. She is a bit of a worrier, though generally good at talking about how she feels.

This is just new to us and wondering whether we should be looking into it further or bearing with it for the moment. I don't want to make anything a bigger deal than it is but equally not overlook something that needs looked into. Planning to speak to nursery to see what they've noticed but wondered if anyone had any advice.

Thanks so much!

I think it is worth speaking to nursery, good to get their input at this point in case you do need to look into it later (and most services seem to have 6 years as a starting point; unless there are very very obvious problems later on).

For context though - I am neurodivergent myself and wasn’t diagnosed with ADHD/ASD until I was an adult.

One of my DD’s is autistic. However, she never had any obvious stims until she was around 8, and she never engaged in echolia. She is academically able and “ masks” well in a school most of the time but has meltdowns and anxiety before and after school.

My other DD did (and still does at times) the repetitive throat clearing. She is not autistic or ADHD and has no particular issues - but she does have mild dyspraxia. For her, the throat clearing seemed to be associated with stressful times and anxiety.

Eldest DS did have echolia from television when young, and was an unusually early talker with an advanced vocabulary. He is definitely not autistic (a young adult now) but I feel confident he has ADHD, we just missed it when he was young as I didn’t know much about it then.

What I’m trying to say (in a very long winded way 😂) is that it could be something or nothing but it worth keeping an eye on. Do you think you or your husband could be neurodivergent but not diagnosed? As it often seems to run in families.

I wish I’d got my DD on the ASD pathway at 6 - as I started to suspect something was going on then - but actually waited until she was 8. There is a long wait on the NHS so I wished I’d got the ball rolling earlier.

We did see a private occupational therapist though, for a sensory integration assessment, and that was very helpful.

Also, when I had the developmental history apt for DD, I found it very hard to remember those early years and hadn’t kept nursery reports etc, so you are doing the right thing to be aware now.

If your DD does go on to need any extra support in school ( and she might not, she might just be a bit of an introvert who needs recovery time after being around people or have sensory issues) then it should be provided based on her needs rather than diagnosis , you don’t have to wait.

*very obvious problems earlier on, not later !

The throat clearing thing is what my ds did, drove me absolutely bat shit,it was so annoying but the poor boy had no clue he was doing it. Usually happened when he was watching television. It lasted a good few months then disappeared overnight never to return. He was about 8 iirc.

Hi there

My daughter repeatedly throat-cleared and had echolalia from about 3yrs old until she was about 7 or 8. She was diagnosed as autistic at 4yrs old.

Vocal tics are common in neurodiverse people but also found in neurotypical people.

If you're concerned it could be linked to something else that it's certainly worth having a chat with your GP.

My child did this and their other behaviours were similar too. He was diagnosed with aspergers and dyspraxia in his teens.

You know it could be part of a bigger picture...or it may just be one of those things and not be! DD had echolalia like this from about four, repeating phrases from tv or songs under her breath over and over. She's also had lots of little noises like throat clearing or little squeaks, nothing massive but a parent notices. She's nine now and is going through the diagnosis for Tourettes, but the echolalia and noises are just part of a bigger picture along with physical tics that has built up gradually over the years.

I don't want to mention Tourettes and freak you out, more so that you can just keep an eye out. I remember googling echolalia when DD was younger and having so many questions as I'd not seen other children do it.

My DS went through a phase of this when he was about 6. I did a lot of worrying and googling but it’s a really common tic that usually just goes away on its own. He did it for about six months I think.

My DS is 4 and will repeat stuff in a whisper under his breath often - mostly it’s either a sentence that he has used that he is especially proud of (eg when he uses a new long word) or stuff we’ve said that has new info for him - in both of these it’s like he’s thinking about the words and processing them. When he’s tired though (bedtime stories v common) he will also just repeat the last few words in a sentence.

I have no other concerns about him at all - he’s bright, lively, met all milestones early as a baby, has lots of friends, enjoys nursery and they have no worries. I did a bit of Googling and freaked myself out but a friend is a speech therapist and she said it’s just a vocal tic and he will most likely grow out of it.

Thank you all so much, these are all such helpful responses. I've spoken to her key worker who was fantastic, has noticed the same and is keeping an eye on how things are at nursery as well as exploring with teacher whether any advice from SALT or anyone else might be a good idea. Will just see how it goes - does seem to be picking up quite a bit so good to be keeping an eye.